Sonothrombolysis of intra-catheter aged venous thrombi using microbubble enhancement and guided three-dimensional ultrasound pulses

Shelby Kutty, Feng Xie, Shunji Gao, Lucas K. Drvol, John Lof, Scott E. Fletcher, Stanley J. Radio, David A. Danford, James M. Hammel, Thomas R. Porter

Research output: Contribution to journalArticle

Abstract

Background: Central venous and arterial catheters are a major source of thromboembolic disease in children. The investigators hypothesized that guided high-mechanical index (MI) impulses from diagnostic three-dimensional (3D) ultrasound during an intravenous microbubble infusion could dissolve these thrombi. Methods: An in vitro system simulating intracatheter thrombi was created and then treated with guided high-MI impulses from 3D ultrasound, using low-MI microbubble sensitive imaging pulse sequence schemes to detect the microbubbles. Ten aged thrombi >24 hours old were tested using 3D ultrasound coupled with a continuous diluted microbubble infusion (group A) and 10 with 3D ultrasound alone (group B). Results: The mean thrombus age was 28.6 hours (range, 26.6-30.3 hours). Group A exhibited a 55 ± 19% reduction in venous thrombus size compared with 31 ± 10% in group B (P = .008). Feasibility testing was performed in four pigs, establishing an in vivo model to investigate further the efficacy of this approach. Conclusions: Sonothrombolysis of aged intracatheter venous thrombi can be achieved with commercially available microbubbles and guided high-MI ultrasound from a diagnostic 3D transducer.

Original languageEnglish (US)
Pages (from-to)1001-1006
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume23
Issue number9
DOIs
StatePublished - Sep 1 2010
Externally publishedYes

Keywords

  • Microbubble
  • Pediatric
  • Sonothrombolysis
  • Three-dimensional echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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